Campbell Barbara K, Le Thao, Tajima Barbara, Guydish Joseph
OHSU/PSU School of Public Health, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, USA.
J Subst Abuse Treat. 2017 Feb;73:40-46. doi: 10.1016/j.jsat.2016.11.002. Epub 2016 Nov 10.
Although individuals in substance use disorders (SUD) treatment continue to smoke at high rates, regulatory, policy and programming changes promoting tobacco cessation are being implemented and some patients quit successfully. We examined associations of smoking patterns, tobacco advertising receptivity, anti-tobacco message awareness, health risk perception, attitudes towards addressing smoking and availability of smoking cessation services with quitting smoking during SUD treatment. Surveys were completed by 1127 patients in 24 programs chosen randomly, stratified by program type (residential, methadone maintenance, outpatient), from among publicly funded, adult treatment programs within the National Drug Abuse Treatment Clinical Trials Network. Among respondents who had been in SUD treatment for at least one month, there were 631 current smokers and 52 former smokers who reported quitting smoking during treatment for at least one month prior to survey completion; these respondents comprised our sample (N=683). Results showed that participants who reported health concerns as a reason for quitting were 1.27 times more likely to have quit during treatment (p=0.015) than those reporting health concerns affected quitting a little or not at all. Additionally, participants who reported that smoking cessation was part of their personal treatment plan during SUD treatment were 1.08 times more likely to have quit during treatment (p<0.001). Participants in methadone treatment were 49% less likely to report successfully quitting during treatment than those in outpatient treatment (95%CI: 0. 35-0.75, p<0.001). Leveraging health concerns about smoking and including smoking cessation in an individualized treatment plan may help increase smoking cessation during SUD treatment.
尽管物质使用障碍(SUD)治疗中的个体吸烟率仍然很高,但促进戒烟的监管、政策和项目变革正在实施,一些患者成功戒烟。我们研究了吸烟模式、对烟草广告的接受度、反烟草信息知晓度、健康风险认知、对解决吸烟问题的态度以及戒烟服务的可获得性与SUD治疗期间戒烟之间的关联。在国家药物滥用治疗临床试验网络中由公共资助的成人治疗项目中,随机选择了24个项目,按项目类型(住院、美沙酮维持治疗、门诊)分层,1127名患者完成了调查。在接受SUD治疗至少一个月的受访者中,有631名当前吸烟者和52名曾吸烟者,后者报告在调查完成前至少有一个月的治疗期间戒烟;这些受访者构成了我们的样本(N = 683)。结果显示,报告健康问题是戒烟原因的参与者在治疗期间戒烟的可能性是那些报告健康问题对戒烟影响很小或根本没有影响的参与者的1.27倍(p = 0.015)。此外,报告在SUD治疗期间戒烟是其个人治疗计划一部分的参与者在治疗期间戒烟的可能性是其他参与者的1.08倍(p < 0.001)。接受美沙酮治疗的参与者在治疗期间报告成功戒烟的可能性比接受门诊治疗的参与者低49%(95%CI:0.35 - 0.75,p < 0.001)。利用对吸烟的健康担忧并将戒烟纳入个性化治疗计划可能有助于增加SUD治疗期间的戒烟率。